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Magnetic resonance navigation for head and neck lesions
S P Davis1, V K Anand, G Dhillon
1Department of Surgery, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Objective:
Review applications of interventional magnetic resonance imaging and describe methods, procedures, and additional instrumentation for the magnetic resonance "operating theater." Describe advantages of magnetic resonance navigation for biopsies of head and neck tumors.
Study Design:
Patients with palpable and nonpalpable head and neck and cranial base tumors were recruited into the study. Patients underwent magnetic resonance-guided biopsy. Retrospective analysis of 21 patients was conducted.
Methods:
0.5 Tesla superconducting open magnetic resonance imaging was used for navigation of the biopsy needle. Patient records and magnetic resonance images were reviewed. The type, size, and location of the lesions were tabulated. Type of anesthesia and monitoring method were analyzed. The histopathologic correlation was conducted in patients who required further surgeries or open surgical biopsies.
Results:
Twenty-two biopsies were carried out in the magnetic resonance suite. One patient required general anesthesia and the other biopsies were conducted under intravenous sedation. There was only one case of nonconcurrence in a patient with Wegener's granulomatosis of the posterior orbit. Overall, a 92% concurrence rate between image-directed fine-needle aspiration, open biopsy, and surgical therapy was encountered. No complications occurred.
Conclusions:
The use of interventional magnetic resonance imaging to assist with fine-needle aspiration core biopsy has made the biopsy procedure safer and more accurate. Potentially morbid and disfiguring surgeries have been avoided in some patients. Deeper lesions have been more easily approached, as the needle for biopsy is under constant magnetic resonance guidance. Improved visualization for critical structures allows safer performance of biopsies. The primary difficulties of open magnetic resonance imaging relate to the need for nonferromagnetic instrumentation and equipment and their high costs. An inverse relationship exists between the imaging quality and the "dead time" required to acquire images.
Insights
Magnetic resonance-guided biopsy of head and neck tumors offers a safer, more accurate alternative to surgery. This interventional magnetic resonance imaging technique achieved a 92% concurrence rate with 0 complications.
Area of Science:
- Interventional Radiology
- Oncology
- Medical Imaging
Background:
- Interventional magnetic resonance imaging (iMRI) provides real-time visualization for minimally invasive procedures.
- Head and neck tumors present unique challenges for biopsy due to complex anatomy and critical structures.
Observation:
- A retrospective analysis of 22 iMRI-guided biopsies in 21 patients with head and neck or cranial base tumors was performed.
- Biopsies were navigated using a 0.5 Tesla superconducting open MRI system.
- Procedures were conducted under intravenous sedation, with one case requiring general anesthesia.
Findings:
- The study achieved a 92% concurrence rate between iMRI-guided fine-needle aspiration and subsequent surgical or open biopsy results.
- No complications were reported in any of the procedures.
- Deeper lesions were more accessible, and critical structures were better visualized, enhancing safety.
Implications:
- iMRI-guided biopsy enhances diagnostic accuracy and patient safety for head and neck tumors.
- This technique can potentially avoid morbid and disfiguring surgical interventions.
- Challenges include the need for specialized nonferromagnetic equipment and associated costs.
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